Sunday was the busiest day for U.S. airports since mid-March, underscoring concerns that a spike in holiday travel may contribute to the spread of the coronavirus, even as new cases remain alarmingly high and officials plead with Americans to avoid taking unnecessary risks.
The Transportation Security Administration screened nearly 1.3 million people on Sunday, the most since March 15, when airline passenger numbers were in free-fall as the pandemic began to take hold within the United States.
Since then, the number of travelers screened at airports has exceeded one million fewer than a dozen times, including around Thanksgiving and Christmas.
About 3.8 million people passed through T.S.A. travel checkpoints between Dec. 23 and Dec. 26, compared with 9.5 million on those days last year.
The surge in holiday travel compared with previous months comes despite warnings from federal officials and soaring U.S. case numbers.
Total infections surpassed 19 million on Saturday, meaning that at least 1 in 17 people have contracted the virus over the course of the pandemic. And the virus has killed more than 333,000 people — one in every thousand in the country. Hospitalizations are hovering at a pandemic height of about 120,000, according to the Covid Tracking Project.
Holiday reporting anomalies may obscure any post-Christmas spike until the second week of January. Testing was expected to decrease around Christmas and New Year’s, and many states said they would not report data on certain days.
The lessons learned from Thanksgiving are mixed. Case numbers and deaths have continued to rise since, but the patterns look more like a plethora of microspreads than a mass superspreader event.
Over all, experts have told The Times, areas of the U.S. that were improving pre-Thanksgiving — like the Midwest — continued to do well afterward, while regions that were seeing higher numbers before the holiday continued to worsen.
It is difficult to trace precisely where infections may occur in a journey — be it in flight, at the airport or at the destination, but travel is a critical factor in the spread of the virus.
U.S. officials said last week that passengers arriving from Britain would be required to test negative for the virus before departing. The new rule came after a new highly transmissible variant of the virus was discovered in that country.
The federal government has imposed some limits on passengers arriving from other countries, but states have largely been left to impose such restrictions domestically and have done so with mixed results. Hawaii, for example, has had relative success in maintaining quarantine restrictions. But most states and the District of Columbia have struggled to keep out travelers or require them to quarantine themselves upon arrival.
Stringent orders requiring most residents of California to stay at home, except for some essential activities, are all but guaranteed to be extended, Gov. Gavin Newsom said on Monday, when some were eligible to end.
“Things, unfortunately, will get worse before they get better,” the governor said at a news conference.
Hospitals — already overwhelmed across much of the state — must prepare for what experts project will be a “surge on top of a surge, arguably on top of another surge,” stemming from travel and socializing over the holidays, Mr. Newsom said.
The state has sent an emergency team to Los Angeles County to help address an influx of patients, who were being turned away from emergency rooms for lack of space at alarming rates over the weekend.
“Routine E.R. care is being slowed,” Mr. Newsom said. “The impact of this pandemic is being felt on the entire hospital system, and could impact each and every one of us — God forbid.”
California has become the epicenter of the pandemic in the United States in recent weeks. The state has reported more than 2 million confirmed coronavirus cases and 24,331 deaths this year, according to a New York Times database.
Intensive care units have been at or near capacity for weeks in Southern California and the Central Valley of the state. Doctors and nurses have been treating some patients in lobbies and hallways. Tents have been erected as waiting rooms, and in some cases, as free-standing field hospitals.
Though most hospitals have not yet formally begun to ration care, experts have said that crowding at the hospitals is likely to result in fewer people seeking care they need, which is probably already causing more deaths.
The current tidal wave of infections in the nation’s most populous state started rising before Thanksgiving. In early December, state leaders announced a plan for regional stay-at-home orders tied to how full intensive care units had become.
The restrictions could expire after three weeks, officials said at the time, if intensive care units in the region were projected to be less than 85 percent full. The idea that the worsening trends in testing and hospitalizations would reverse, or at least level off, within three weeks seemed optimistic, but theoretically possible.
But the Southern California region, which includes Los Angeles, Orange and San Diego counties, exceeded the threshold almost immediately after the plan was announced. So did capacity in the San Joaquin Valley, which has been particularly hard-hit throughout the pandemic. And the situation has not improved.
Now, some 98 percent of Californians across the vast state are living under the restrictions, which prohibit gatherings of people from different households and require restaurants to serve only takeout.
When the orders affecting Southern California and the San Joaquin Valley reached the three-week mark on Monday, Mr. Newsom said it was “self-evident” that they would need to be extended, but that officials were still putting together detailed data.
He said the state secretary of health and human services, Dr. Mark Ghaly, would probably make the extensions official on Tuesday.
Coronavirus deaths in Spain reached 50,000 the fourth European nation to do so, after Italy, Britain and France.
Spain undertook one of the most restrictive lockdowns in the spring. It ended its first state of emergency in June, but a merciless second wave that began in August has continued through the fall and into the winter, even as Spain returned to a state of emergency in October.
The health ministry said on Monday that it had registered 50,122 dead since the start of the pandemic, after adding 298 fatalities since its last count last week.
More than one-fifth of Spain’s deaths occurred this year in the capital region of Madrid, where the regional authorities have this week put 10 areas under tighter lockdown rules, amid concerns over another increase in infections. Regions like the Balearic Islands and Navarra are also tightening restrictions this week, while the health authorities in Andalusia said on Monday that they had detected five cases of the new coronavirus variant originating from Britain.
Alongside other European Union countries, Spain started its mass vaccination program on Sunday, with the goal of inoculating 2.5 million people between January and March. The first shots went to residents of nursing homes and the health care professionals who look after them.
Spain plans to collect and share with other E.U. nations information about residents who decide not to get vaccinated for Covid-19, the country’s health minister said on Monday. Spain’s health minister, Salvador Illa, stressed that vaccination would not be made compulsory, but, he said, a register would be set up that would include all the people who turned down the vaccine after being called up for vaccination by Spain’s public health service.
“Vaccination refusals will be kept in a register,” Mr. Illa said in an interview with La Sexta, a Spanish television channel. “This is not a public document and it will be done with the highest respect of data privacy.”
On Monday, José Luis Martínez-Almeida, the mayor of Madrid and spokesman of the main opposition Popular Party, blamed the government for “a shortage of information” about the vaccine, which has meant that many people are still reluctant to get it.
The vaccination plan should be “an exercise in transparency, not propaganda,” Mr. Martínez-Almeida said in an interview with Spanish national radio.
In other developments around the world:
Not wearing a mask in public is now a criminal offense in South Africa, as recorded coronavirus infections have surged to over one million since the start of the pandemic. Offenders face up to six months in prison, a fine or both. “This is a drastic measure, but is now necessary to ensure compliance with the most basic of preventive measures,” President Cyril Ramaphosa said on Monday. Scientists discovered a variant of the virus that accounts for the vast majority of samples tested in the current wave. Mr. Ramaphosa also announced a national curfew from 9 p.m. to 6 a.m., the closure of the country’s beaches and the prohibition of gatherings. South Africa will likely gain access to a Covid-19 vaccine in the second quarter of 2021, he said.
China warned against Lunar New Year travel in February after finding cases in Dalian, a northern port city, and Beijing, the capital. After months of near-zero case numbers that have allowed life to largely return to normal, the country of 1.4 billion people has recorded 42 locally transmitted cases in the past week, many of them were of unknown origin. In line with the government response to previous outbreaks this year, officials have been testing hundreds of thousands of people in Beijing and millions in Dalian, and residents of Dalian have been advised not to leave the city. China plans to vaccinate 50 million people.
At a news conference on Monday, Alain Berset, the health minister of Switzerland, responded to reports of British tourists fleeing the ski resort of Verbier in the middle of the night to avoid being quarantined for the holidays. “I don’t know where they went,” he said. “I think they just went home.” The Swiss government has imposed a 10-day quarantine on anyone who arrived in Switzerland from Britain after Dec. 13, so British tourists already in the country faced the prospect of spending the rest of their holidays watching people ski from their hotel rooms, rather than skiing themselves. Switzerland is one of the only places in Europe where ski slopes are open.
Indonesia will bar entry to international visitors for two weeks from New Year’s Day to stem the spread of new, potentially more contagious strains of the coronavirus, Reuters reported, with an exemption only for high-level government officials. The country barred travelers from Britain a few days ago, and tightened rules for those arriving from Europe and Australia, expanding on an earlier tourism ban.
South Korea has discovered three cases of the virus variant first detected in Britain, officials said on Monday. All were in members of a London-based family who arrived in the country on Dec. 22, according to the Korea Disease Control and Prevention Agency. All three have been in isolation since testing positive on arrival. South Korea, which is struggling to contain a third wave of infections, is among dozens of countries that have temporarily banned flights from Britain. The country of about 50 million people reported 808 new cases on Monday, bringing the national total to 57,680, with 819 deaths.
Frontline workers in Sydney, Australia, will not be allowed to watch the New Year’s Eve firework display from the city’s harbor as planned, Gladys Berejiklian, premier of the state of New South Wales, said Monday, citing a growing coronavirus outbreak in the city’s northern suburbs. Other restrictions announced for Dec. 31 include lowering a limit on outdoor gatherings to 50 from 100 and barring people who live outside the central business district from entering unless they have a venue booking and an entry permit.
Correction: Dec. 28, 2020
An earlier version of this article misstated that Spain was the third European nation to reach 50,000 coronavirus deaths. Spain is the fourth E.U. nation to do so, after Italy, Britain and France.
The New York Legislature is expected to pass one of the most comprehensive anti-eviction laws in the nation on Monday, as the state contends with high levels of unemployment and a pandemic that has taken 37,000 lives statewide.
For months, tenants and advocacy groups have been dreading the end-of-year expiration of eviction bans that have kept people in their homes despite their inability to pay rent. Under the new measure, landlords would be barred from evicting most tenants for at least another 60 days.
A tenant in danger of being kicked out of a home could submit a document stating financial hardship related to the coronavirus to postpone an eviction.
The legislation would also make it harder for banks to foreclose on smaller landlords who are themselves struggling to pay bills. But advocacy groups for landlords said the bill could leave many in the lurch.
The Legislature is convening an unusual special session between Christmas and New Year’s to pass the measure, acting quickly because the governor’s executive order barring many evictions is expiring on Dec. 31.
Legislators expect Gov. Andrew M. Cuomo will sign the measure, which would go into effect immediately. Mr. Cuomo’s office had no immediate comment on the legislation.
As of late November, there were 38 requests for eviction warrants in New York City, according to a recent analysis by the New York University Furman Center. Every one of those cases began before the pandemic and most involved properties in central Brooklyn.
Tenant lawyers and advocacy groups said the state law would prevent landlords from throwing thousands of financially strapped renters onto the streets in the winter as virus case numbers continue to rise.
“It’s going to save a lot of people’s homes,” said Ellen Davidson, a staff attorney at the Legal Aid Society. “It’s going to save lives.”
But landlords argue that the bill oversteps, allowing tenants to avoid eviction by merely stating financial hardship rather than proving it.
“With no requirement of proof that the Covid-19 pandemic negatively affected their income, and no income limitation to qualify for eviction protection, a tenant whose household income went from a half-million dollars to $250,000 would qualify for eviction protection by declaring that their income has been ‘significantly reduced,’” said Joseph Strasburg, president of the Rent Stabilization Association, a landlord group.
Almost immediately, Dr. Hisam Goueli could tell that the patient who came to his psychiatric hospital on Long Island this summer was unusual.
The patient, a 42-year-old physical therapist and mother of four young children, had never had psychiatric symptoms or any family history of mental illness. Yet there she was, sitting at a table in a beige-walled room at South Oaks Hospital in Amityville, N.Y., sobbing and saying that she kept seeing her children, ages 2 to 10, being gruesomely murdered and that she herself had crafted plans to kill them.
“It was like she was experiencing a movie, like ‘Kill Bill,’” Dr. Goueli, a psychiatrist, said.
The only notable thing about her medical history was that the woman had become infected with the coronavirus in the spring. She had experienced only mild physical symptoms from the virus, but, months later, she heard a voice that first told her to kill herself and then told her to kill her children.
Dr. Goueli was unsure whether the coronavirus was connected to the woman’s psychological symptoms. “But then,” he said, “we saw a second case, a third case and a fourth case, and we’re like, ‘There’s something happening.’”
Indeed, doctors are reporting similar cases across the country and around the world. A small number of Covid patients who had never experienced mental health problems are developing severe psychotic symptoms weeks after contracting the coronavirus.
Beyond individual reports, a British study of neurological or psychiatric complications in 153 patients hospitalized with Covid-19 found that 10 people had “new-onset psychosis.” Another study identified 10 such patients in one hospital in Spain. And in Covid-related social media groups, medical professionals discuss seeing patients with similar symptoms in the Midwest, Great Plains and elsewhere.
“My guess is any place that is seeing Covid is probably seeing this,” said Dr. Colin Smith at Duke University Medical Center in Durham.
Medical experts say they expect that such extreme psychiatric dysfunction will affect only a small proportion of patients. But the cases are considered examples of another way the Covid-19 disease process can affect mental health and brain function.
The Maryland biotech Novavax is starting a final, so-called Phase 3 clinical trial in the United States and Mexico for its experimental coronavirus vaccine, the company announced on Monday.
The little-known firm, which has never brought a vaccine to market before, received up to $1.6 billion from the federal government’s Operation Warp Speed this summer to expedite development. The company reported robust results in earlier phases of its trial, showing that the vaccine prompted strong immune responses in monkeys and people.
The company began a Phase 3 trial of 15,000 people in Britain in September and expects to report preliminary results from that study in the first quarter of next year. It had intended to start its U.S. trial in October but delayed it because of manufacturing problems.
The Novavax vaccine, known as NVX-CoV2373, works differently than the ones by Pfizer and other companies that have already been shown to be effective. It contains artificially produced viral proteins, along with an immune-boosting compound derived from the soapbark tree.
The vaccine, given in two doses, three weeks apart, is designed to teach the immune system to recognize the protein. Later, if vaccinated people get infected with coronaviruses, their antibodies can attack them, while immune cells can destroy virus-harboring cells.
NVX-CoV2373 must be kept refrigerated but does not require freezing, making its storage easier than the vaccines from Moderna and from Pfizer and BioNTech, which have to be transported at ultracold temperatures.
Three other protein-based coronavirus vaccines are also in Phase 3 trials in Australia, Canada and India.
Novavax will run its trial at 115 sites in the United States and Mexico, enrolling as many as 30,000 people. Two-thirds will receive the experimental vaccine, and the rest a placebo. Novavax said it would recruit a diverse group, including Black and Latino volunteers. They plan for one-quarter of their participants to be older than 65.
“With the Covid-19 pandemic raging around the globe, this trial is a critical step in building the global portfolio of safe and effective vaccines to protect the world’s population,” Stanley C. Erck, the president and chief executive of Novavax, said in a statement.
The sight of lines of people camped on the sidewalk overnight used to mean that playoff tickets or a new sneaker would be going on sale in the morning. But in one southwest Florida town, it was not trend-chasing teenagers or rabid sports fans this time, it was seniors, and the scarce commodity they were after was a coronavirus vaccine.
The Florida Department of Health in Lee County announced on Sunday that the Moderna vaccine would be available at the parks building in Estero, Fla., starting at 2 p.m. Monday to people 65 and older, as well as “high-risk frontline health care workers.” There was no list, no appointments were scheduled — the first 300 qualified people who showed up would get a shot.
People started lining up within hours, The News-Press newspaper in Fort Myers, Fla., reported. They brought lawn chairs, blankets and thermos bottles.
One woman in the line told The News-Press that her granddaughter, who just turned 1, was on her mind as she waited to get a shot.
“This is my birthday present to her,” she said. “I’ve never been able to see her.”
The first-come, first-serve method stood in contrast to the carefully orchestrated approach at most settings where the two authorized Covid-19 vaccines have been doled out so far. The first hospitals to administer the vaccine have generally been drawing up prioritized lists and assigning appointed times.
But as the nationwide vaccination effort expands, scenes like the one outside the Estero Park and Recreation Center on Monday will surely grow more common. Six more sites in Lee County plan to give the vaccine in the same manner on Tuesday and Wednesday.
More than 1.9 million people across the United States have received the vaccine as of Saturday, and the federal government said it shipped at least 9.5 million doses to states, territories and government agencies, each with its own distribution plan.
The Centers for Disease Control and Prevention recommended last week that after health care workers and nursing home residents, the next groups to be vaccinated should be people older than 74 and “frontline essential workers,” followed by people 65 to 74 and anyone with serious underlying medical conditions regardless of age.
But Gov. Ron DeSantis of Florida issued an executive order the next day allowing health care providers to vaccinate anyone older than 65 right away.
Gov. Andrew M. Cuomo of New York announced on Monday that the state’s positive test rate had surpassed 8 percent, the highest daily figure since May and a sharp rise even as officials anticipate a larger spike after the holiday season.
Still, Mr. Cuomo was reluctant to raise alarms about the metric, which was at 8.3 percent on Sunday, because of anomalies in testing and reporting around the holidays.
In the days before Christmas, more New Yorkers were tested across the state than usual, most likely in preparation for small gatherings and holiday travel. The number of tests then fell by more than 75,000 over the weekend, and Mr. Cuomo said officials are looking at whether that too affected the metric.
“The sample is artificially skewed,” Mr. Cuomo said.
After Christmas Day, a higher proportion of tests came from urgent care clinics, he said, which may indicate that the people seeking a test were more likely to have symptoms, as opposed to those who generally go for precautionary tests.
Officials will continue monitoring the state’s progress over the next few days, he added, to further determine whether the rise was an aberration or an indication that the coronavirus is measurably advancing.
Since the start of the pandemic, New York has recorded nearly 930,000 cases, and 37,000 people have died, according to a New York Times database.
Weeks ago, New York officials were most concerned about containing the spread in Buffalo and its surrounding suburbs, where, in November, hospitalizations surpassed the extreme levels seen in the spring. But since then, Mr. Cuomo said, the area “has actually made good progress.”
The communities surrounding Albany in upstate New York, the Finger Lakes region and the Mohawk Valley area — where the seven-day average positive test rate was 8.46 percent — are sparking the most concern. “You bring it down in one region, it pops up in another,” he said.
In New York City, Staten Island continues to raise the greatest worries. The seven-day positive test rate in the borough, which has been one of the centers of rebellion in the city over local and state virus-related restrictions since the spring, was 5.44 percent. Residents have pushed back against the city’s restrictions and appeals to wear masks.
“This is just pure people’s behavior and people’s attitude — and the community’s attitude,” Mr. Cuomo said.
President Trump signed a $900 billion pandemic relief bill on Sunday and funded the government through September. The measure restarts unemployment benefits that had lapsed on Saturday, extends an eviction moratorium, provides money to states for vaccine distribution and replenishes a loan program for small businesses.
It will also provide stimulus checks of $600 for most Americans, a bit of welcome news in a tough holiday season. For months, Americans, like people everywhere, have had to make difficult choices about where to go and whom to see, as the coronavirus pandemic rages across the globe. Those narrowing choices, hard even during times of lower infection rates, have been especially amplified as the holidays have coincided with record-shattering numbers.
Adding to the physical toll of the virus are the economic repercussions, as the millions who lost their jobs this year can so readily attest. Mr. Trump had withheld his support of the bill in part because he said the direct payments to many Americans should be $2,000, and not the $600 provided in the legislation.
The United States reported 225,930 new cases on Dec. 26, according to a New York Times database, continuing a slight downward trend in the numbers, but still a staggering figure. As case counts remained steady, and hospitalizations increased, California’s worsening outbreak muffled progress in other parts of the country. In parts of the state — the wealthiest and most populous in the country — every I.C.U. bed is filled.
Dr. Anthony Fauci warned again of especially challenging months ahead. “We very well might see a post-seasonal — in the sense of Christmas, New Year’s — surge,” Dr. Fauci said on the CNN program “State of the Union.”
“We’re really at a very critical point,” he said. “If you put more pressure on the system by what might be a post-seasonal surge because of the traveling and the likely congregating of people for, you know, the good warm purposes of being together for the holidays, it’s very tough for people to not do that.”
And while many people reduced the size of their gatherings or gave up travel this year, others defied the pleas of public health experts and the Centers for Disease Control and Prevention.
Several days around the Christmas holiday saw some of the busiest air travel of the pandemic, according to data from the Transportation Security Administration. More than one million people passed through T.S.A. checkpoints each day of the weekend before Christmas, and again on Dec. 23 and the day after Christmas — a number reached only a few times since March, including during the Thanksgiving holiday week.
Since surfacing in a seafood and poultry market in China in December 2019, the coronavirus has spread to nearly every country, upended daily life and derailed the global economy. It has killed more than 1.6 million people and sickened more than 76 million worldwide over the last year. The World Health Organization has declared the situation a pandemic.
Several world leaders, including President Trump and Prime Minister Boris Johnson of Britain, contracted the virus as they worked to mitigate its spread within their borders, proving even the most powerful could fall to the virus’s grip.
Scientists around the world moved quickly to produce an effective vaccine, and by this month several nations had started administering inoculations to their most vulnerable residents in an effort to bring the virus under control.
We’ve put together a timeline, charting the pandemic’s course over the past year.
then & now
As 2020 comes to a close, we are revisiting subjects whose lives were affected by the pandemic. When Manny Fernandez first encountered Holly Montoya in November, he wasn’t able to catch her name or talk to her. Later, she reached out and shared her story.
Families of those infected with the virus stood outside a New Mexico hospital that November night, staring in pain through windowpanes. This was as close as they could get to their loved ones at Memorial Medical Center in Las Cruces. I watched as they put their palms and crucifixes against the glass, Duct-taped crosses in the City of Crosses.
A stranger approached on the sidewalk.
She hardly said a word as she walked up behind two families. She carried two pizza boxes. She handed a pizza to one family and the second pizza to the other. She wore a mask, but her eyes were filling with tears. She was gone in seconds, walking quickly back down the sidewalk.
One of the families, the relatives and friends of Sylvia Garcia, 60, turned around, stunned, their focus on the I.C.U. windows interrupted by a warm gift on a cold night from an anonymous stranger.
I never caught the woman’s name. After we wrote about that moment in Las Cruces, she contacted me and my colleague, Jack Healy.
Her name is Holly Montoya, 55. She and her husband had driven by the hospital the night before. They saw the families huddled outside the windows.
“I just wanted to do something nice for them,” she told me recently. “I knew how they felt.”
Ms. Montoya’s mother, Sherry Baca, 78, had Covid-19, too.
“I feel kind of silly because it was such a little thing,” Ms. Montoya said. “I’m reading about all these people giving out 1,500 meals. I wanted to tell them why I was doing it and about my mom and all that, but I just couldn’t. I’m not a good cry talker. My eyes hopefully told them my story.”
It was Nov. 18 when I saw Ms. Montoya outside the hospital. She lost her mother to the coronavirus soon after, on Nov. 22. Ms. Garcia died days later, on Nov. 29.
We are a divided country, in the grip of a deadly pandemic. But our unspoken connections outnumber our spoken divisions. We stand suffering at our individual walls, until strangers approach from behind, bearing love and pizza.